Overdose with Phenazepam
Phenazepam is one of the most powerful tranquilizers of the benzodiazepine series. It is used in the treatment of hypochondriacal conditions, phobias, panic attacks, psychosis, neuroses, insomnia, alcoholic delirium, convulsive syndrome. Treatment with Phenazepam is carried out exclusively as prescribed by a doctor and under his supervision, since the haphazard use of the drug can cause serious complications, one of which is an overdose.
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What dose of Phenazepam is needed for an overdose?
The dose of Phenazepam is selected by the doctor individually, taking into account the patient's illness, his general condition, age and many other factors. So, with insomnia, Phenazepam is usually taken 30-40 minutes before bedtime in a dose of 0.5-1 mg. For relief of alcoholic or drug withdrawal, the daily dose of Phenazepam is 2.5–5 mg. The maximum daily dose of the drug for patients with epilepsy is 2.5-10 mg, divided into several doses at regular intervals. For some psychiatric diseases, for example, personality depersonalization, Phenazepam can be prescribed in very high daily doses (up to 20 mg), but this therapy is allowed only in a hospital setting.
The danger of Phenazepam is that in some cases, even a slight excess of the therapeutic dose can lead to an overdose. A single dose of 10 mg of Phenazepam can cause severe poisoning with a fatal outcome.
It is unacceptable to use Phenazepam in conjunction with alcohol-containing agents (drinks and medicines), since alcohol potentiates the depressing effect on the central nervous system. As a result, taking even the right dose can cause an overdose.
Signs of overdose
The severity of an overdose with Phenazepam depends on the number of tablets taken, the time interval between taking them, as well as their combination with alcohol or other drugs.
For mild to moderate overdose, the following are characteristic:
- confusion of consciousness;
- drowsiness followed by deep sleep;
- lowering blood pressure (BP);
- heart rhythm disturbances;
- constipation or, conversely, diarrhea;
- nausea and vomiting;
- increased salivation (hypersalivation);
- acute urinary retention or involuntary urination.
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If the maximum permissible dose is significantly exceeded, severe intoxication develops, its signs:
- shallow irregular breathing;
- convulsions;
- severe cardiovascular failure;
- coma.
A general blood test reveals thrombocytopenia, anemia, leukopenia, and neutropenia. Often, severe overdose of Phenazepam causes kidney damage with the development of acute renal failure.
First aid for overdose with Phenazepam
First aid for an overdose of Phenazepam should be provided as soon as possible. If the victim is conscious:
- Rinse the stomach: drink about 1 liter of hypertonic salt solution (2-3 tbsp. Table salt per 1 liter of water), then, pressing on the root of the tongue, induce vomiting.
- Take enterosorbent (Smecta, Activated carbon, Enterosgel, etc.).
If the victim is unconscious, he must be turned on his side and made sure that he remains in this position until the ambulance arrives - this will prevent obstruction of the airways with vomit or a sunken tongue.
Antidote
The antidote to Phenazepam is Flumazenil (Anexat). The drug blocks benzodiazepine receptors, thereby allowing to neutralize the sedative and hypnotic effects of Phenazepam.
When is medical attention needed?
In case of an overdose with Phenazepam, specialized medical care is needed in 100% of cases, the sooner it is provided, the more chances for a successful outcome. Therefore, as soon as the fact of an overdose with Phenazepam is established, an ambulance team should be called, and only then proceed to provide first aid.
Patients are subject to compulsory hospitalization in the toxicology department of the hospital. Treatment includes the following measures:
- Gastric lavage using a gastric tube.
- Intravenous administration of Flumazenil. It should be borne in mind that this drug is contraindicated in patients with epilepsy or combined poisoning with Phenazepam and proconvulsants (Amitriptyline, Aminophylline). In these cases, a forced diuresis with alkalinization of urine is indicated.
- Symptomatic treatment aimed at maintaining vital functions: drugs are prescribed that stimulate the central nervous system, support respiratory and cardiovascular activity.
Possible consequences
The body's recovery is slow. For a long period, there is an uncertain gait, impaired coordination of movements, a depressive state caused by toxic and hypoxic encephalopathy. A frequent consequence of an overdose of Phenozepam is a persistent dysfunction of the liver and / or kidneys, up to the development of their failure.
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Elena Minkina Doctor anesthesiologist-resuscitator About the author
Education: graduated from the Tashkent State Medical Institute, specializing in general medicine in 1991. Repeatedly passed refresher courses.
Work experience: anesthesiologist-resuscitator of the city maternity complex, resuscitator of the hemodialysis department.
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
